Comments on: Open Mic Weekend

By: Hueydoc

Hueydoc — Thu, 05 May 2011 04:16:17 +0000

I cannot help but wonder if there is a secondary gain- we now have to transfer them to the mother hospital ( by EMS) – do they get billed for 2 ER visits and an ambulance transfer ?

By: igloodoc

igloodoc — Thu, 05 May 2011 03:39:01 +0000

In our case, our counsel agreed. They also checked with JC and state regulators. OB ultrasound is not available to anyone, anymore regardless of insurance. Thus, no EMTALA issues, and any hospital with OB ultrasound becomes a higher level of care.

Interesting that JC understands that different hospitals have different capabilities, and thus the medical screening exam can be different. As it was explained to us, the screening exam (and all tests) must be the same for insured and uninsured. The content of the exam (and screening tests) is not the issue. So, as in the ‘House of God’, if you don’t have a thermometer you won’t find a fever (and the associated liability)

So, as malpractice insurers figure out that it is safer to be able to do less, then that will be the trend. Sadly, we are already seeing this, and what could be handled locally is now transferred (dumped) to higher level of care.

Good care — no. Medico-legally defendable care — yes.

By: WhiteCoat

WhiteCoat — Wed, 04 May 2011 04:07:12 +0000

Hospitals can expand the number of rooms all they want. Unless they have the staff to move the patients, the expanded rooms will become glorified waiting rooms.
AAEM has a position statement that docs should not see more than 2.5 patients per hour in a moderate acuity ED (15% admit rate). That’s single coverage for a 22,000 visit emergency department, which I think would be pretty tough.

Hospital needs to be very careful about eliminating after hour ultrasounds. If they provide the ultrasounds during working hours but not at off hours, then they are asking for EMTALA violation. Either they provide the services all the time or they don’t provide the services at all. Tell your administrators to run that decision by their legal counsel.

By: WhiteCoat

WhiteCoat — Wed, 04 May 2011 03:50:55 +0000

I personally think it would be better to wait until you’ve got a year under your belt in residency. That way, your team knows you and you’ll have time to arrange coverage for maternity leave.
Trying to study and care for a child in medical school would be a very challenging task.

By: WhiteCoat

WhiteCoat — Wed, 04 May 2011 03:46:34 +0000

I don’t know that there is a right answer.
On one hand, virulent organisms kill you if you’re exposed.
On the other hand, immunizations have save the lives of millions.
Some of it has to do with timing. A large dose of infectious agent in an open wound really can’t enhance your immunity, so sterility and cleanliness is important. However, smaller doses of known antigens can prime your immune system – hence the benefits of flu shots.
If you want to take some advice from Grandma WhiteCoat, she always used to say “everyone eats a bushel of dirt before they die.”

By: Hueydoc

Hueydoc — Wed, 04 May 2011 03:03:40 +0000

After you are 50- you’ll finally have paid off your student loans by then.

By: KT

KT — Tue, 03 May 2011 08:22:45 +0000

Are you trying to tell me people get sick outside of business hours???

By: Wondering

Wondering — Mon, 02 May 2011 14:07:24 +0000

When in medical school/training is the best time to get pregnant?

By: igloodoc

igloodoc — Mon, 02 May 2011 03:37:12 +0000

We ship them to the nearest facility with OB that hasn't closed yet .. $600 per transport. Good news, it's the people's insurance plan, for the most part. What is really interesting is the P&B at 38 weeks and delivery is imminent. Almost all are hi risk (druggies or no prenatal care, etc). And we have the privilege of being legally tethered to the polybabydadic offspring for 18 years... (if the don't play first string QB for the Colts it was birth trauma, according to John Edwards' expert ho). Nothing like watching a beautiful new life coming into the world, and the new mom playing "Who's your daddy" for real. Makes me misty. Certainly no "hostile legal climate" here. My Chakra Healing stick makes it all just a bad dream.

By: Hueydoc

Hueydoc — Mon, 02 May 2011 01:55:06 +0000

Yet the rate of asthmatics continues to skyrocket- at the same time we’ve got completely enclosed air conditioned houses, cars and schools.